Provider Demographics
NPI:1073113981
Name:ELDERCARE HEALTHCARE SERVICES LLC
Entity Type:Organization
Organization Name:ELDERCARE HEALTHCARE SERVICES LLC
Other - Org Name:ELDERCARE HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:VAUGHN
Authorized Official - Middle Name:
Authorized Official - Last Name:DANAO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-299-3110
Mailing Address - Street 1:5660 W FLAMINGO RD STE C
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-2312
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5660 W FLAMINGO RD STE C
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-2312
Practice Address - Country:US
Practice Address - Phone:702-744-7420
Practice Address - Fax:702-829-8397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-29
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV10118-HPC-0OtherNEVADA DEPARTMENT OF HEALTH AND HUMAN SERVICES